Table 2 Methods of priority setting with examples of action and change

Trusted historical relationships

Discussion and on-going dialogue through contact between academics and senior managers in the Trusts, usually linked to joint academic-practice posts

Development of implementation projects linked to areas of clinical importance and quality incentives called Commissions for Quality and Innovation (CQUINs).

Improvements in patient safety and quality of care

CQUINs target achieved with financial incentive to Trust

Research questions to answer immediate clinical issues, e.g., poor control of young diabetics, poor attendance of young diabetics in NHS clinics

Changes in care pathways for young diabetics shaped by research

Platforms for negotiation and planning

Steering groups and strategy groups/special interest groups to develop ideas

Developing projects linked to service needs,

e.g., development of social marketing tools to recognise signs of stroke in Black and minority Ethnic communities

Marketing tools used in practice

These groups include representatives from university and NHS stakeholders, many had service user representatives

Projects linked to changes in care pathway, for example, nutritional support for chronic obstructive pulmonary disease (COPD) patients

Some were developed as part of the CLAHRC infrastructure, whilst pre-existing platforms were co-opted by CLAHRC themes, for example, a Stroke Strategy Group

Implementing tele-care into a COPD care pathway

Changes in care pathways evident

Health impacts on patients identified through evaluation

Decisions not to change a pathway based on evaluation results (tele-health project)

Formal methods of consensus

Delphi and nominal group technique were used to inform projects to take to the next phase of a mental health project

Both formal processes selected projects that were undertaken in practice

Potential impact on patients and changes in care pathways if supported by findings

Co-production workshops linked to obesity research