ARC West’s funding ended on 31 March 2026. This site is an archive and is no longer updated.
1 October 2019
Hello, thanks for reading my first blog post as Director of our NIHR Applied Research Collaboration, ARC West. First things first, what’s in a name? Some people call us “Ay Are See” West – which signals we belong to the family of NIHR-supported research infrastructure programmes that includes the “Bee Are Sees” – NIHR Biomedical Research Centres – our richer, more famous big sisters. Or you can call us “ARC West” as in “Noah’s Ark”. Personally, I prefer the latter, as it invokes an image of us sailing through floods and stormy seas towards a better, healthier tomorrow. More on this metaphor later.
Some of you may be understandably unsure about what ARCs are and what they’re meant to do. You’re off to a head start if you vaguely understand what CLAHRCs were (fwiw Collaborations for Leadership in Applied Health Research and Care). ARCs are the new CLAHRCs and their mission is the same – to enable the co-production of research projects that produce evidence to underpin better health and care services, enabling them to more effectively address key health priorities.
There are 15 ARCs across England and each has a primary focus on the health and care priorities across its own footprint. For ARC West, this extends from Gloucester, down to Weston-Super-Mare then across to Swindon, a population of 2.5 million people. Over the last 18 months we’ve listened to the views of patients, people who provide care, people who plan, commission, and pay for care and people who do research on what our priorities are in the West. A clear and consistent picture has emerged.
Though parts of the West are affluent, we are also home to some of the most disadvantaged communities in England. I work as a GP in Hartcliffe, south Bristol. Children in our practice are in the bottom 10 (not 10 per cent) for indicators of childhood deprivation out of well over 7,000 practices in England. In other communities in the West (for example in parts of Weston-Super-Mare) childhood deprivation is even worse, and childhood poverty is growing across the West as a whole. Because of this, one of the four ARC West research themes is healthier childhoods. We will work with our colleagues in primary care, child health, child and adolescent mental health, children’s social care, as well as police and schools. With them we will build the evidence base to enable frontline services, working with children and their families, to do a better job in their fight to reduce the harm caused by childhood adversity and deprivation.
At the other extreme of the life course the West is also home to a growing proportion of older adults, many of whom experience a complex combination of health and social problems. Health and care services generally struggle to help these people in an effective, holistic, humane and efficient way. Our second theme on integrated and optimal care will focus on improving the health and care service response to complex multimorbidity. We will work with our partners who use, provide and pay for hospital care to find ways to ensure it’s used in the best way, ensuring the most benefit to all the people that need it at an affordable cost.
In the West we have higher than national average rates of self-harm and suicide, and of common mental disorders like anxiety and depression. Inevitably these problems are related to social and economic disadvantage but are also present at unacceptably high rates amongst students at our higher education institutions. So mental health is our third theme, focusing on creating care pathways that more effectively reduce suicide and self-harm, particularly amongst students and people experiencing economic hardship. It will also be a priority to develop, implement and evaluate ways to increase access to psychological treatments that are of proven effectiveness but which are only reaching a fraction of the people who could benefit from them.
Our fourth theme is public health and prevention. This reflects our priority to reduce the adverse health consequences of human behaviours that are often framed as individual choices, but in reality are shaped by the contingencies of people’s lives and the opportunities available to them. Childhood obesity is one of the most important examples of such a complicated, socially patterned problem that has proven extremely resistant to simplistic solutions. Our projects in this theme involve partnerships, often with voluntary sector community-based organisations, to enable accessible forms of physical activity and improve children’s food environment. We will also focus on reducing the multiple harms that result from addiction, both to legal and illegal drugs.
Over the next five years we will work alongside the public, patients and our partners to agree research questions on the priorities described above. Questions that, if we had the answers, could make the biggest difference. The resulting projects will be supported by the ARC West core team of around 20 experts in the research methods needed to find reliable answers. The expertise in our team covers all the important bases: using health and care services data to improve those services, and demonstrating what works in the real world; reviewing and synthesising the best available evidence; establishing value from investment and better understanding the experiences of both patients and service providers.
At the top of this blog I mentioned floods and stormy seas; I’m very excited about the next five years but to be honest I’m also a little nervous. We face considerable challenges that it would be a mistake to underestimate. Inevitably we won’t have the capacity to do all the things we might do, so we will need to make choices and agree priorities. Some people are likely to be disappointed and, in some cases, the only consolation we will be able to offer is that the process that led to their disappointment was robust, fair and transparent.
People are also impatient: they want answers to important questions now, not tomorrow. We understand the needs of decisionmakers and the importance of agility, but good research takes time. The challenge is to respond as rapidly as possible without compromising the quality of the evidence we provide. Good research also often provides unexpected and awkward answers that may run counter to established wisdom and vested interests, and may seem to threaten common assumptions and prejudices. We need to be pragmatic and recognise the constraints on change that operate in the real world but we also need to maintain our integrity. Ultimately, we will be judged on whether the change we bring about has positive, measurable and important impact on people’s health and wellbeing.
Though we start from a local perspective we also have a wider view. Many good things we discover will have relevance beyond the West and we need to work with colleagues across the national network of ARCs and Academic Health Science Networks (AHSNs) to ensure important innovation is adopted and spread as widely as possible. Through CLAHRC West we have established a track record of doing this successfully.
I often think that the NIHR set up the ARCs (and the CLAHRCs before them) to do the thing that they realise they don’t do very well and would like to do better, but don’t really know how. Fundamentally this “thing” is to respond to the needs for evidence of a health and care system that aspires to be evidence-based, in an effective, efficient and agile way. This is our mission – we’ve chosen to accept it (how could we possibly not?). We have a fantastic and experienced team and this is probably the single thing that reassures me most that we will succeed. Please join me in wishing us the best of luck. I hope to get back to you with updates on our progress as regularly as possible.